Endoscopic Management of 108 Sinus Mucoceles

Abstract

There is increasing evidence in the literature that endoscopic management of sinus mucoceles results in long-term control with recurrence rates at or close to 0%. Rhinologic surgeons should consider the endoscopic technique as the surgical treatment of choice.

Endoscopic sinus surgery for paranasal sinus mucocoele with orbital involvement

“…Most patients had patent sinus ostia and none had dural injury as has been previously reported. 10,13 None required external sinus or orbital surgery as definitive management even though most of our patients had significant orbital extension with 73% demonstrating globe displacement. These results suggest that a direct orbital approach is uncommonly, if ever, required.…”

“…It also has a significant morbidity as stripping of the mucocoele lining occasionally leads to dural injury and CSF leaks. 2,9,10 Obliteration of the involved sinus is not recommended if there is erosion of the sinus bony wall with extension of the mucocoele either intracranially or into the orbit. The mucosa lining the mucocoele becomes adherent to either the dura or the orbital periosteum and cannot be removed during the surgery without significant risk of injury to the adjacent structures.…”

“…1 Over the past decade, intranasal drainage and marsupialization of mucocoeles using ESS has emerged as definitive management, with minimal morbidity and a low recurrence rate. [3][4][5][6][7][8][9][10][11][12] With the advent of more advanced instrumentation, refined surgical techniques, and intraoperative imaging, even the more technically challenging frontal mucocoeles can be approached endoscopically.…”

Giant Mucocoele of the Maxillary Antrum: A Case Report

“…The recommended treatment for maxillary sinus mucocoeles with no extension to soft tissues of the cheek is endoscopic evacuation with wide middle meatal antrostomy [5]. A Caldwell Luc approach may be needed for mucocoeles that have extended into facial soft tissues, pterygomaxillary fossa or those which have not been satisfactorily evacuated by endoscopic sinus surgery.…”

Delayed development of frontal mucocele after fronto-orbital advancement in a child with craniosynostosis

“…Treatment of mucoceles consists of removal of the mucocele by an obliteration procedure and a marsupialization that attempts to enhance ventilation. It has been recommended that in patients who do not have progressively aggravating neurologic symptoms, marsupialization may be the primary mode of treatment, followed by an additional obliteration procedure, if necessary [4,9,14,15].…”